Psychedelic drug use in healthy individuals: A review of benefits, costs, and implications for drug policy

This review (2017) shifts the usual focus from psychedelics as a potential treatment for mental health problems to psychedelics as a potential enhancer of well-being in healthy individuals. The author argues that the relatively low risk and high potential benefit of psychedelic drugs are incongruent with the stringent drug laws seen around the world.

Abstract

“The potential of psychedelic drugs in the treatment of mental health problems is increasingly being recognized. However, relatively little thrust has been given to the suggestion that individuals without any mental health problems may benefit from using psychedelic drugs, and that they may have a right to do so. This review considers contemporary research into the use of psychedelic drugs in healthy individuals, including neurobiological and subjective effects. In line with findings suggesting positive effects in the treatment of mental health problems, such research highlights the potential of psychedelic drugs for the enhancement of wellbeing even in healthy individuals. The relatively low risk associated with usage does not appear to align with stringent drug laws that impose heavy penalties for their use. Some policy implications, and suggestions for future research, are considered.”

Author: James W. B. Elsey

Summary

Researchers are increasingly recognizing the potential of psychedelic drugs in the treatment of mental health problems, but relatively little thrust has been given to the suggestion that individuals without any mental health problems may benefit from using psychedelic drugs.

Researchers and clinicians are becoming increasingly open to the possibility that psychedelic drugs may prove useful in the treatment of mental health problems. However, due to restrictive drug laws, research into psychedelic drugs was effectively foreclosed in the 1960s.

Even healthy individuals can experience considerable benefits from consuming psychedelics, and may have a right to experience these. However, due to the lack of evidence for strong mood enhancing effects of pharmaceuticals in healthy individuals, it is unlikely that a large number of otherwise healthy individuals would seek out psychedelic experiences.

This review provides an up to date overview of current knowledge regarding psychedelic drug effects in healthy individuals, and considers possible adverse effects.

psychedelic state

Psychedelic drugs include dimethyltryptamine (DMT), lysergic acid diethylamide (LSD), mescaline (found in peyote), and psilocybin (found in magic mushrooms), and have been used for their mind-altering properties for thousands of years.

Shortly after drug administration, a short-term acute psychedelic state is induced, followed by a long-term psychedelic afterglow state, which may include a sense of unity, ineffability, a deep positive mood, a sense of sacredness or awe, transcendence of time and space, and a noetic quality.

Neurobiology of psychedelic drugs

Neuroscience research has recently begun to investigate the acute effects of psychedelic drugs on the human brain.

Studies of the psychedelic state typically show changes in the connectivity and activity of brain regions constituting the ”default mode network” (DMN), particularly the posterior cingulate cortex (PCC) and medial prefrontal cortex (mPFC).

Although the integrity of communication between brain regions within the DMN appears to be decreased by psychedelic drugs, there are also increases in connectivity between brain regions that are usually more independently functioning, and this may explain the unusual insights and perspectives that frequently become available under the influence of psychedelics.

Psychedelic drugs affect brain regions with a high density of serotonin 2 A (5-HT2A) receptors, and ketanserin, a 5-HT2A receptor antagonist, completely blocks the subjective effects of LSD.

Agonistic effects of psychedelics may underpin long-term changes in the brain, including decreased expression of 5-HT2A receptors, which are overexpressed in humans with depression and are targets of antidepressant drugs.

Effects of psychedelic drugs in healthy individuals

Psychologists have been studying the psychological effects of psychedelic drugs for several decades. These drugs can induce profound mystical or spiritual experiences in healthy individuals, with potentially transformative effects.

In a classic study known as ”The Good Friday experiment”, participants who received psilocybin or nicotinic acid felt a greater sense of meaning and purpose in their lives, oneness with humanity, and decreased valuation of superficial pursuits such as material gains and social status.

Recent studies have found that psilocybin can produce a mystical experience in healthy volunteers. These participants reported increased sense of wellbeing and life satisfaction, as well as moderate positive changes regarding behaviors in relationships and caring for themselves.

Schmid et al. (2015) found that LSD increases psychological states such as oneness, disembodiment, and personal wellbeing and trust, and that autonomic and endocrine measurements may prove informative in mapping how neural changes translate to physiological effects and subjective experiences.

Taking LSD in combination with listening to music may lead to particularly emotive experiences. The appropriate use of music can be tailored to maximize the chances of achieving new and positive breakthroughs.

Psychedelics may facilitate creative pursuits, as evidenced by the changes in some features of drawings produced by visual artists after LSD sessions, and the enduring impact of mescaline on creative problem solving several weeks later.

In a recent study, participants who took ayahuasca displayed increased originality in a standardized test of creative thinking. Hence, both experimental studies and anecdotal reports indicate that psychedelics may enhance the creative process.

Studies using experimental tasks 2 – 3 hours after the peak effects of LSD administration have shown that social and emotional processes are affected by psychedelics. Participants were impaired at recognizing fearful faces, and displayed greater feeling for and arousal over people pictured in emotionally provocative scenes.

Psychedelic drugs may help improve wellbeing among otherwise healthy individuals, by improving mood and anxiety, and by giving access to states of consciousness and insights of great significance. This may help foster the resolution of professional and personal challenges.

Possible adverse effects

With any intervention, one should always consider the associated risks. With regards to psychedelics, Griffiths et al. (2008) summarize possible risks that have been raised by other commentators, including acute panic, the manifestation or exacerbation of psychiatric conditions, and enduring perceptual disturbances.

Psychedelic drugs can induce panic and exacerbation of psychiatric issues. Some participants in studies noted feeling of panic while on the drug, though these feelings typically dissipated over the session. In controlled studies of ayahuasca, participants experienced unpleasant states in the acute phase after drug intake, but these feelings were balanced or even outweighed by feelings of awe and other positive emotions, as well as longer-term improvements in wellbeing.

Carhart-Harris et al. (2016) found a positive correlation between thought disorganization and later increases in openness, suggesting that the psychedelic experience may directly relate to later positive changes.

While some reports of negative effects of psychedelic drugs have been exaggerated, it is possible that being surrounded by other psychedelic nave users and inadequate preparation can contribute to negative outcomes.

It is often difficult to disentangle the direct effects of psychedelic drugs from other drugs, or the influence of premorbid risk factors in case studies reporting adverse reactions to psychedelic drugs.

Beyond a few exceptional case studies, there is little evidence for serious adverse effects in relation to the use of ayahuasca, at least in ritual contexts. In fact, independent population studies have found no evidence for a link between psychedelic use and mental health problems or suicidality.

No evidence has been found that psychedelic use leads to enduring perceptual disturbances. This is true even in ritual users who typically have much greater exposure than participants in experimental studies.

Although psychedelic drugs do not have addictive properties, their dependence and compulsive use can lead to a range of problems. However, they are being investigated as a potential means of treating addiction.

Long-term, frequent use of psychedelics might be linked to brain and personality changes. However, these brain changes are not necessarily negative, and ayahuasca users actually outperformed nonusers on a range of neuropsychological tests.

In summary, scientific research suggests that psychedelic drugs have a very good safety profile, may even indicate protective effects, and do not lead to drug dependency. However, psychedelic drugs can be dangerous if used at improper dosages, in combination with other drugs, or in an unsafe environment.

Drug policy and psychedelic use in the healthy population

Several countries have made exemptions for the use of psychedelics in religious practices. The Santo Daime and Uniao de Vegetal have been granted freedom of use in the United States, while the German government has deemed ayahuasca to be a public health risk.

Exemptions for religious purposes raise questions regarding appropriate definitions of religion, and some commentators have argued that such considerations may be beside the point. Instead, a broader exemption can be made for the use of psychedelic drugs on the grounds of cognitive liberty.

Religious legitimacy typically makes distinctions between ‘merely’ philosophical perspectives and religious views, making access to potentially life enhancing experiences and insights off limits to those who do not hold mystical beliefs.

The use of psychedelic drugs for the purpose of treatment has also been a subject of debate. Current research suggests that these drugs may allow otherwise healthy individuals to improve themselves and increase their wellbeing, with no apparent cost – and possibly benefits – to those around them.

The distinction between treatment and enhancement may still make sense in healthcare settings, but it raises problems for the clarity of law, as it does not track any meaningful change in the cost to society or benefits that might be gleaned by individuals.

Some policy developments may be proceeding without due consideration of different drugs and their effects. The Psychoactive Substances Act, which aims to prohibit psychoactive substances, ignores benefits people might derive from a psychoactive substance and even sidesteps the need to demonstrate potential for harm.

Psychedelics are relatively easy to procure illegally, but the risk of consuming them is likely to be higher than where use is legalized. Furthermore, ‘copycat’ substances are sometimes produced to avoid trouble with the law, and their risk profile may differ markedly from known psychedelics.

Several suggestions have been made regarding how policy regarding psychedelics might be made more reasonable, including considering the benefits of usage outside of strictly medical settings, and monitoring the production, purity, and sale of the drugs to increase safety and revenue.

Conclusion

Researchers have urged the reclassification of psychedelic drugs so that their therapeutic potential can be fully realized. However, current results suggest that healthy individuals can also benefit from the use of psychedelic drugs.

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